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OVERVIEW OF PROGRESS ON HEALTH CARE WITH
REFERENCE TO MDGs IN SOUTH ASIA
(5th ARM, 23-24 January 2006, Agra)
India Experience
OneWorld South Asia, New Delhi
www.oneworldsouthasia.net
Health Sector Covers
• Hospitals
• Clinics
• Nursing Homes
• Civil Infrastructure
• Doctors
• Paramedical Staff
• Medicines/Drugs
• Equipments & Devices
• Chemist Shops
• Maintenance
Issues
• Limited Public Resources
 Plan Outlay For Health During 3rd Plan 1961-66 was
only 2.6%, Reduced To 1.4% In 1997-2002
 Now, Government Spending Is 0.9% of GDP
• Poor quality of services through public health
infrastructure
 Sub centres, PHCs, CHCs, district hospitals &
tertiary hospitals
 Doctors, paramedical staff
 Medicines, devices and equipments
 Monitoring – eg TB
 Poor maintenance
 Poor accessibility (distance) and affordability
(including transportation)
Issues
contd …..
• Conflict of interest of different systems of medicine
 Allopathy
 Ayurvedha
 Siddha
 Unani
 Homeopathy
• Disease burden
 Diarrhoea – leading cause of child deaths; 19.2% children below
the 3 years of age suffer from diarrhoea
 35% of infants are not fully immunised – 90% in Bihar, 81% in UP
 TB – cases 85 lakhs; 2 lakhs die each year
 HIV/AIDS cases 51 lakhs
 Cancer – 75 lakhs diagnosed each year
 Cardiovascular diseases – 3.8 crores
 Diabetic patients – 3.3. Crores; 50,000 loose their legs
 Mental disorders – 6.5 to 7 crores
Disease Burden - India
contd …..
Potential interventions
• 80% provided by private sector
•
of health service providers –
medical, nursing, pharmacy councils, drug
quality control
Pre-natal diagnostic techniques (PNDT) Act,
amended in Feb 2003
• Prohibits and disclosure of sex of the foetus
• Prohibits advertisements
• Punishable with imprisonment and fine
National rural health mission (NRHM), 2005
• Give more powers to the village councils
• Availability and accessibility of quality healthcare especially for
the rural people, poor, women and children
• To cover 3,00,000 villages
• To revitalise local health traditions – ISM, AYUSH
• Success depends on alertness of civil society
• Golden triangle partnership mission to develop drugs for 13
specific diseases
• National health programmes – TB, leprosy, HIV/AIDS, etc.
Some ICT experiences
• E-health cards – Sirsa, Haryana
• Info-kiosk: n-Logue – Aravind Eye Hospital, Madurai
• Telemedicine
• Ek Duniya Sawal Jawab: IVRS technique – Drishtee, Haryana
and Bihar; Tarahaat, UP and MP
• Phone-in radio programmes: Aravis, Gurgaon, Haryana
• Dgroups: Pro-poor hiv/aids strategies
www.dgroups.org/groups/hiv-aids
What MSPs can do?
• Interface with governments, NGOs/CSOs and community
through multi-stakeholder partnership model (MSP)
• Disease surveillance and monitoring
• Facilitate in sourcing content from the society (pull)
• Disseminate content (push) from NGOs/CSOs, Govt., to the
community
• Capacity building
• Assess community needs, then develop/use suitable tools